How to use: Print and Fill in each day with all food, drink and snacks you have eaten. Everything needs to be recorded as accurately as possible including added salt, sugar and sweeteners. Include portion sizes. Use the Bristol Stool chart to describe your poos every day. Include colour, odour and amount of toilet paper used.
Example:
| Monday | Food | Drinks | Poo Dairy |
| Morning | 2 x vogels toast with butter and jam on both. | Cup of tea with 1 sugar.
1 glass water. 1 glass water. 1 glass water. |
Woke with loose stools – BSC Type 6. Used lots of toilet paper. Light brownish. Not much odour. |
| Midday | Sushi roll with chicken and avocado. Orange.
Afghan and several handfuls of raw almonds with tea. |
1 glass water.
1 cup instant coffee 1 sugar, milk. 1 cup of tea with milk. |
Bloated
No energy drop today after afternoon tea. |
| Evening | Casserole with meat, veges and potatoes – bowl 1 serve only. Homemade.
Ice-cream – 3 dessert spoons with canned boysenberries – 3 dessertspoons. |
1 glass water. | Gas and wind this evening, smelly. Started after ice-cream and fruit. |
Bristol Stool Chart {BSC} Ratings: Rate your poos daily with the help of the Bristol Stool Chart. 
Tip: Look before you wipe!
Print and bring to your consultation.
Name:
| Monday | Food | Drinks | Poo Dairy |
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| Tuesday | Food | Drinks | |
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| Wednesday | Food | Drinks | Poo Dairy |
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| Thursday | Food | Drinks | Poo Dairy |
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| Saturday | Food | Drinks | Poo Dairy |
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| Sunday | Food | Drinks | Gut Symptoms |
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